2015至2017年全国34家医院髋膝关节置换术后假体周围感染翻修率调查  

Revision rate of periprosthetic joint infection post total hip or knee arthroplasty of 34 hospitals in China between 2015 and 2017: a multi-center survey

作　　者：彭慧明[1] 周宗科[2] 赵建宁 王飞[4] 廖威明[5] 张文明[6] 蒋青[7] 严世贵[8] 曹力[9] 陈廖斌[10] 肖骏 许伟华[12] 何瑞 夏亚一[14] 徐永清 许鹏[16] 左建林[17] 胡懿郃[18] 王万春[19] 黄伟[20] 王金成 陶树清[22] 钱齐荣 王英振[24] 张志强[25] 田晓滨 王文波[27] 金群华[28] 朱庆生 袁宏[30] 尚希福 史占军[32] 郑稼[33] 许建中[34] 刘建国[35] 徐卫东 翁习生[1] 邱贵兴[1] Peng Huiming;Zhou Zongke;Zhao Jianning;Wang Fei;Liao Weiming;Zhang Wenming;Jiang Qing;Yan Shigui;Cao Li;Chen Liaobin;Xiao Jun;Xu Weihua;He Rui;Xia Yayi;Xu Yongqing;Xu Peng;Zuo Jianlin;Hu Yihe;Wang Wanchun;Huang Wei;Wang Jincheng;Tao Shuqing;Qian Qirong;Wang Yingzhen;Zhang Zhiqiang;Tian Xiaobin;Wang Wenbo;Jin Qunhua;Zhu Qingsheng;Yuan Hong;Shang Xifu;Shi Zhanjun;Zheng Jia;Xu Jianzhong;Liu Jianguo;Xu Weidong;Weng Xisheng;Qiu Guixing(Department of Orthopedic Surgery,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100730,China;Department of Orthopaedics,West China Hospital of Sichuan University,Chengdu 610041,China;Department of Orthopaedics,General Hospital of Eastern War Zone,People′s Liberation Army,Nanjing 210002,China;Department of Orthopedic Surgery,Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Department of Orthopedic Surgery,First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510008,China;Department of Joint Surgery,First Affiliated Hospital of Fujian Medical University,Fuzhou 350009,China;Department of Orthopedic Surgery,Drum Tower Hospital of Nanjing University,Nanjing 210008,China;Department of Orthopaedic Surgery,Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310058,China;Department of Orthopaedic Surgery,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Orthopaedic Surgery,Central South Hospital of Wuhan University,Wuhan 430071,China;Department of Orthopaedic Surgery,Wuhan Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China;Department of Orthopedic Surgery,Wuhan Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430032,China;Department of Orthopedic Surgery,the Southwest Hospital of Army Medical University,Chongqing 400038,China;Department of Orthopedic Surgery,Second Hospital of Lanzho

机构地区：[1]中国医学科学院北京协和医院骨科,北京100730 [2]四川大学华西医院骨科,成都610041 [3]解放军东部战区总医院骨科,南京210002 [4]河北医科大学第三医院骨科,石家庄050051 [5]中山大学附属第一医院骨科,广州510008 [6]福建医科大学附属第一医院关节外科,福州350009 [7]南京大学鼓楼医院关节外科,南京210008 [8]浙江大学医学院附属第二医院骨科,杭州310058 [9]新疆医科大学第一附属医院关节外科,乌鲁木齐830054 [10]武汉大学中南医院骨科,武汉430071 [11]华中科技大学同济医学院附属武汉同济医院骨科,武汉430030 [12]华中科技大学同济医学院附属武汉协和医院骨科,武汉430032 [13]陆军军医大学西南医院关节外科,重庆400038 [14]兰州大学第二医院骨科,兰州730030 [15]解放军联勤保障部队第920医院,昆明650032 [16]西安交通大学附属西安红会医院关节外科,西安710054 [17]吉林大学中日联谊医院骨科,长春130031 [18]中南大学湘雅医院骨科,长沙410008 [19]中南大学湘雅附属第二医院骨科,长沙410016 [20]重庆医科大学附属第一医院骨科,重庆400010 [21]吉林大学白求恩第二医院骨科,长春130021 [22]哈尔滨医科大学附属第二医院骨科,哈尔滨150001 [23]上海长征医院关节外科,上海200030 [24]青岛大学附属医院关节外科,青岛266003 [25]山西医科大学附属第二医院骨科,太原030001 [26]贵州医科大学附属医院骨科,贵阳550000 [27]哈尔滨医科大学第一附属医院骨三科,哈尔滨150000 [28]宁夏医科大学附属医院骨科,银川750010 [29]空军军医大学西京医院,西安710032 [30]新疆维吾尔自治区人民医院关节外科,乌鲁木齐830002 [31]中国科学技术大学附属第一医院(安徽省立医院)关节外科,合肥230001 [32]南方医科大学附属南方医院关节外科,广州510515 [33]河南省人民医院骨科,郑州450003 [34]郑州大学附属第一医院骨科,郑州450002 [35]吉林大学�

出　　处：《中华医学杂志》2023年第13期999-1005,共7页National Medical Journal of China

摘　　要：目的调查全国范围2015至2017年髋/膝关节置换手术量及因假体周围感染(PJI)接受翻修的比例及其病例资料。方法流行病学调查。于2018年11月至2019年12月采用方便抽样方式及自行设计的问卷调查全国41家医院;根据骨骼肌肉感染协会的标准诊断PJI。通过检索各医院住院患者数据库获得PJI患者的资料。从临床记录中提取问卷条目。收集后计算PJI翻修手术的比例,比较髋/膝PJI翻修患者临床资料的差异。结果全国36家医院(87.8%)报告了数据,2015至2017年共实施髋膝关节置换术99791例次,因PJI翻修946例次(0.96%)。髋PJI总翻修率为0.99%(481/48574),2015至2017年分别为0.97%(135/13963)、0.97%(153/15730)和1.07%(193/17881);膝PJI总翻修率为0.91%(465/51271),2015至2017年分别为0.90%(131/14650)、0.88%(155/17693)和0.94%(179/18982);黑龙江(2.2%,40/1805)、福建(2.2%,45/2017)、江苏(2.1%,85/3899)、甘肃(2.1%,29/1377)和重庆(1.8%,64/3523)报告的翻修率较高。结论2015至2017年全国34家医院总体感染翻修率为0.96%;其中髋PJI翻修率略高于膝PJI;不同地区医院翻修率存在差异。Objective To investigate the rate of periprosthetic joint infection(PJI)revision surgeries and clinical information of hip-/knee-PJI cases nationwide from 2015 to 2017 in China.Methods An epidemiological investigation.A self-designed questionnaire and convenience sampling were used to survey 41 regional joint replacement centers nationwide from November 2018 to December 2019 in China.The PJI was diagnosed according to the Musculoskeletal Infection Association criteria.Data of PJI patients were obtained by searching the inpatient database of each hospital.Questionnaire entries were extracted from the clinical records by specialist.Then the differences in rate of PJI revision surgery between hip-and knee-PJI revision cases were calculated and compared.Results Total of 36 hospitals(87.8%)nationwide reported data on 99791 hip and knee arthroplasties performed from 2015 to 2017,with 946 revisions due to PJI(0.96%).The overall hip-PJI revision rate was 0.99%(481/48574),and it was 0.97%(135/13963),0.97%(153/15730)and 1.07%(193/17881)in of 2015,2016,2017,respectively.The overall knee-PJI revision rate was 0.91%(465/51271),and it was 0.90%(131/14650),0.88%(155/17693)and 0.94%(179/18982)in 2015,2016,2017,respectively.Heilongjiang(2.2%,40/1805),Fujian(2.2%,45/2017),Jiangsu(2.1%,85/3899),Gansu(2.1%,29/1377),Chongqing(1.8%,64/3523)reported relatively high revision rates.Conclusions The overall PJI revision rate in 34 hospitals nationwide from 2015 to 2017 is 0.96%.The hip-PJI revision rate is slightly higher than that in the knee-PJI.There are differences in revision rates among hospitals in different regions.

关 键 词：关节成形术 置换 髋 关节成形术 置换 膝 感染 翻修 率 

分 类 号：R687.4[医药卫生—骨科学]